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Case Report: Lung Ultrasound for the Guidance of Adjunctive Therapies in Two Invasively Ventilated Patients with COVID-19.
Pierrakos, Charalampos; Attou, Rachid; Iesu, Enrica; Baelongandi, Hugues; Honore, Patrick M; Bos, Lieuwe D J; Schultz, Marcus J; De Bels, David.
  • Pierrakos C; Department of Intensive Care, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
  • Attou R; Department of Intensive Care, Brugmann University Hospital, Université Libre de Bruxelles, Brussels, Belgium.
  • Iesu E; Department of Intensive Care, Brugmann University Hospital, Université Libre de Bruxelles, Brussels, Belgium.
  • Baelongandi H; Department of Anesthesiology, Brugmann University Hospital, Université Libre de Bruxelles, Brussels, Belgium.
  • Honore PM; Department of Anesthesiology, Brugmann University Hospital, Université Libre de Bruxelles, Brussels, Belgium.
  • Bos LDJ; Department of Intensive Care, Brugmann University Hospital, Université Libre de Bruxelles, Brussels, Belgium.
  • Schultz MJ; Department of Respiratory Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
  • De Bels D; Laboratory of Experimental Intensive Care and Anesthesiology (LEICA), Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Am J Trop Med Hyg ; 103(5): 1978-1982, 2020 11.
Article in English | MEDLINE | ID: covidwho-750523
Semantic information from SemMedBD (by NLM)
1. Lung LOCATION_OF Ultrasonography
Subject
Lung
Predicate
LOCATION_OF
Object
Ultrasonography
2. Ultrasonography DIAGNOSES Patient ventilated
Subject
Ultrasonography
Predicate
DIAGNOSES
Object
Patient ventilated
3. Ultrasonography ADMINISTERED_TO Patients
Subject
Ultrasonography
Predicate
ADMINISTERED_TO
Object
Patients
4. COVID-19 CAUSES Respiratory Failure
Subject
COVID-19
Predicate
CAUSES
Object
Respiratory Failure
5. Respiratory Failure PROCESS_OF Patients
Subject
Respiratory Failure
Predicate
PROCESS_OF
Object
Patients
6. Lung LOCATION_OF Ultrasonography
Subject
Lung
Predicate
LOCATION_OF
Object
Ultrasonography
7. Ultrasonography DIAGNOSES Patient ventilated
Subject
Ultrasonography
Predicate
DIAGNOSES
Object
Patient ventilated
8. Ultrasonography ADMINISTERED_TO Patients
Subject
Ultrasonography
Predicate
ADMINISTERED_TO
Object
Patients
9. COVID-19 CAUSES Respiratory Failure
Subject
COVID-19
Predicate
CAUSES
Object
Respiratory Failure
10. Respiratory Failure PROCESS_OF Patients
Subject
Respiratory Failure
Predicate
PROCESS_OF
Object
Patients
ABSTRACT
Two patients with respiratory failure due to confirmed COVID-19 were examined using bedside lung ultrasound (LUS) shortly after intubation and start of invasive ventilation. In the first patient, LUS revealed extensive atelectatic areas. A recruitment maneuver was applied, resulting in some reaeration of areas that showed atelectasis, and some improvement in oxygenation was observed. Oxygenation improved further with the use of prone positioning. In the second patient, LUS showed diffuse abnormalities without atelectatic areas, and ventilation proceeded without a recruitment maneuver but with prone positioning. These two cases illustrate how LUS could be useful in identifying different lung morphologies early after the start of invasive ventilation and help decide on adjunctive therapies. This has possible implications for ventilator management in resource-limited settings, with limited availability of chest computed tomography and blood gas analyzers. Tailoring invasive ventilation based on LUS findings early after the start of invasive ventilation is feasible, but this should be further evaluated in future studies.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Ultrasonography / Coronavirus Infections / Lung Type of study: Diagnostic study / Clinical Practice Guide / Prognostic study Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: Am J Trop Med Hyg Year: 2020 Document Type: Article Affiliation country: Ajtmh.20-0538

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Ultrasonography / Coronavirus Infections / Lung Type of study: Diagnostic study / Clinical Practice Guide / Prognostic study Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: Am J Trop Med Hyg Year: 2020 Document Type: Article Affiliation country: Ajtmh.20-0538